Health, Medical & Scientific

Sep201430

Blood thinners ‘exacerbated’ bleeding in pensioner, court hears
Radiologist failed to spot small bleed in brain on a CT scan

Dublin Coroner’s Court heard that doctors treated the woman with blood thinners for a suspected coronary problem, but she deteriorated overnight and a subsequent scan showed she had developed a ‘massive’ subdural haematoma. Photograph: Dara Mac Dónaill/The Irish Times

Gareth Naughten

Mon, Sep 29, 2014, 22:14

First published: Mon, Sep 29, 2014, 20:13

A pensioner was given blood thinners after a radiologist failed to spot a small bleed in her brain on a CT scan, an inquest in Dublin heard. Dympna Halpin (74), from Killeary, Lobinstown, in Navan, Co Meath, later developed a huge bleed on the brain, which led to her death at Beaumont Hospital, Dublin, on October 26th, 2012.

Dublin Coroner’s Court heard that a CT brain scan carried out when Mrs Halpin presented at Our Lady’s Hospital, Navan, with a history of falls on October 14th, 2012, was reported as being normal. Doctors treated her with blood thinners for a suspected coronary problem, but she deteriorated overnight and a subsequent scan showed she had developed a “massive” subdural haematoma or bleed on the brain.

Returning a verdict of medical misadventure, Dublin coroner Dr Brian Farrell said the blood thinners had exacerbated the rate of bleeding.

The inquest heard that the scan was organised by Dr Murat Kirca when Mrs Halpin was admitted to Our Lady’s Hospital. Doctors suspected she had acute coronary syndrome, but the scan was ordered to rule out a subdural haematoma. Giving evidence, consultant radiologist Dr John Hanson said he had reviewed the scan on his computer at home and believed it was “entirely normal”.

Low doses

When the CT scan was reported as normal, Mrs Halpin was given low doses of the anti-clotting agents Plavix and Clexane. Overnight she began to complain of headaches and was vomiting. The next day her neurological status began to drop and a second CT scan was ordered, which showed a significant haematoma. She was transferred to Beaumont Hospital, where the bleed was evacuated. She showed an improvement following the operation; however, her condition deteriorated and she subsequently died.

Dr Kirca said that, had the subdural haematoma been reported, he would “probably not have given Plavix”.

Dr Hanson told the court that on reviewing the scan later, a “very tiny, shallow, subdural collection” is evident. When pressed by counsel for the Halpin family, Sara Antoniotti, that it was found in an area where one “commonly encounters subdural haematomas”, he said he “did not appreciate it on the day”. He told the court: “That is something I have to live with.”

Software less ‘efficient’

The software he used at the time is not as “efficient” as the hospital system, Dr Hanson said. Since February, radiologists have been working from the same IT system whether in hospital or at home, the court heard. The inquest also heard from consultant neuroradiologist Dr Paul Brennan, who said he had shown the scan to several “general radiologist consultants” and the subdural was “completely missed by them”.

Dr Farrell stressed that his verdict of medical misadventure had no connotations of malpractice by anyone involved.

Aug201422

Ebola hemorrhagic fever is a severe and often deadly illness that can occur in humans and primates (e.g. monkeys, gorillas).

Ebola hemorrhagic fever has made worldwide news because of its destructive potential.

Causes

Ebola hemorrhagic fever (Ebola fever) is caused by a virus belonging to the family called Filoviridae. Scientists have identified five types of Ebola virus. Four have been reported to cause disease in humans: Ebola-Zaire virus, Ebola-Sudan virus, Ebola-Ivory Coast virus, and Ebola-Bundibugyo. The human disease has so far been limited to parts of Africa.

The Reston type of Ebola virus has recently been found in the Philippines.

The disease can be passed to humans from infected animals and animal materials. Ebola can also be spread between humans by close contact with infected body fluids or through infected needles in the hospital.

Symptoms

During the incubation period, which can last about 1 week (rarely up to 2 weeks) after infection, symptoms include:

Exams and Tests

Tests to show whether someone has been exposed to the Ebola virus (virus-specific antibodies)

Treatment

There is no known cure. Existing medicines that fight viruses (antivirals) do not work well against Ebola virus.

The patient is usually hospitalized and will most likely need intensive care. Supportive measures for shock include medications and fluids given through a vein.

Bleeding problems may require transfusions of platelets or fresh blood.

Outlook (Prognosis)

As many as 90% of patients die from the disease. Patients usually die from low blood pressure (shock) rather than from blood loss.

Possible Complications

Survivors may have unusual problems, such as hair loss and sensory changes.

When to Contact a Medical Professional

Call your health care provider if you have travelled to Africa (or if you know you have been exposed to Ebola fever) and you develop symptoms of the disorder. Early diagnosis and treatment may improve the chances of survival.

Prevention

Avoid areas in which there are epidemics. Wear a gown, gloves, and mask around sick patients. These precautions will greatly decrease the risk of transmission.

Aug201411

Why the St James’s site is wrong for the national children’s hospital
Opinion: ‘I have presented 22 major reasons for its unsuitability. Construction costs on this site alone will add a minimum of €150 million compared to a green field site’

As developer of three hospitals in this country, the Blackrock, Galway and Hermitage Clinics, I have learned significant lessons from these experiences.

Such lessons prove that the choice of the St James’s Hospital site to locate the proposed children’s hospital is ill-founded and inappropriate.

The site, when cleared, is reported to be twice the size of the Mater site. However, the constraints in relation to access, parking, sewerage, height, lack of a green environment and most of all the lack of potential for further expansion and development automatically should have ruled it out as a choice.

I have previously presented 22 major reasons for its unsuitability. Construction costs on this site alone will add a minimum of €150 million compared to a green field site.

An ideal site exists adjacent to an adult teaching hospital at Blanchardstown, where a maternity hospital can also be co-located.

Planning and designing modern medical facilities that are to serve the children of our nation for the next half-century require considerable flexibility.

The Blackrock Clinic in its 25 years has doubled in size. The parking demands have more than doubled with the addition of a multi-storey car park on adjacent land. This is despite excellent public transport, both bus and Dart routes.

The Galway Clinic in 10 years has already had six additional construction programmes, including trebling of the parking requirement, the addition of a 50 per cent increase in its accommodation, doubling its daycare facility, as well as other new facilities.

The architectural firms proposed to design the new hospital include an international firm BDP which has been involved in the design of the new Alder Hey Children’s Hospital in Liverpool. This has been described as the hospital in the park.

The architects have stressed the need for open space, a green environment for the children to enjoy, and low rise buildings. Could anything contrast more with what is proposed for the St James’s site?

Written to the Taoiseach

Efforts to express my concerns to the previous minister of health, James Reilly, have been unsuccessful. He was unable to meet me since last December despite numerous requests. I have also written to the Taoiseach and all members of the Cabinet, and have unsuccessfully attempted to arrange a meeting with Enda Kenny over the past six months, both to express my concern, and on a positive side to offer my support to spearhead a state of the art world class hospital on the site at Blanchardstown, on a philanthropic basis, with a small group of like-minded concerned citizens.

This would also be co-located with an adult teaching hospital.

My request for clarity under the Freedom of Information Act as to where the €37 million was spent on the design for the failed Mater proposal, has been unanswered, despite sending my €15 in the envelope! Perhaps no one knows where the money went to and that would explain the lack of response. Eight months is a long time awaiting a reply.

A new hospital on the St James’s site can be squeezed in, but is it appropriate? As a nation this is a decision that future generations will regret forever. If this project proceeds it will prove to be the worst decision ever made in hospital planning.

Our new Minister for Health has an opportunity to review the situation and prevent a catastrophic error in planning our future health infrastructure.

These are the major reasons why St James’s is unsuitable.

nThe proposed children’s hospital is four times the size of the previously proposed co-located hospital. This resulted in over 50 objections to the planners.

nProposed size is 108,000sq m. To accommodate this building nine storeys in height will be required in places. Adjacent houses are two-storey.

A minimum of 50,000sq m is required for expansion in the short term, and is not available.

nInadequate car parking. Some 2,500 slots required initially for the children’s hospital alone. Between 750 and 1,000 slots are planned, none for the staff.

nSome10,000 car movements will be generated daily by the children’s hospital on a site that already can take 45 minutes to exit at busy periods.On street parking on already crowded roads will lead to further congestion.

nNo space for helicopter access at ground level and rooftop landing is far from ideal.

nThe Drimnagh sewer runs from north to south on the site. Two sewers run in 8 and 10 metre tunnels. Sewers attract numerous rats to the site.

nNumerous other unmapped services run across the site and require to be located and diverted.

nTo accommodate parking three underground levels need excavation. This adds hugely to the cost of construction, undermines adjacent buildings, necessitates high energy costs on an ongoing basis for lighting and mechanical ventilation. Even with these spaces parking capacity is totally inadequate.

nInaccessible city site increases construction costs by approximately 10 per cent.

nUtilisation of the St James site for the children’s hospital will prevent further development of the adult hospital and more importantly a collocated maternity hospital.

How many more reasons do we require to realise the magnitude of the inexplicable choice for the location of the new children’s hospital. It is still not too late for the Government to admit it erred and reverse its decision.

James M Sheehan is co-founder and developer of the Blackrock,Galway and Hermitage Clinics

Jul201407

Opinion: Both the Supreme Court and the European Court of Human Rights recognise the importance to a child of accessing information about biological identity

‘There is also growing evidence that access to identifying information about one’s genetic parents is essential to the mental health of individuals who have been donor-conceived.’ Photograph: Getty Image

The general scheme of the Children and Family Relationships Bill 2014 is laudable in that, among its many family law reform-oriented aims, it seeks to regulate parentage where a child is born via assisted human reproduction.

Essentially, the commissioning couple (whether opposite-sex or same-sex), will be regarded as the child’s parents, provided that certain criteria are fulfilled under the proposed legislation.

However, it does not contain any provision enabling a child born via assisted reproduction to acquire details about its biological parents on reaching age 18, even though in its 2005 report the Commission on Assisted Human Reproduction recommended donor-conceived children should on maturity “be able to identify the donors involved”.

In order to enable this right of a donor-conceived child to be enforced on maturity, an increasing number of countries have enacted laws prohibiting anonymous donation of sperm.

In the UK, a change in the law occurred on April 1st, 2005, prohibiting anonymous donation of sperm and consequently children born via assisted reproduction after that date have the right to obtain non-identifying information about their donor at age 16, and identifying information, such as the donor’s name and address, at 18.

Collecting and registering

The Human Fertilisation and Embryology Authority is responsible for collecting and registering relevant information about donors from the UK fertility clinics and it will release such information to a donor-conceived child.

However, we should not be too critical of the failure of the Oireachtas to include a similar provision in the general scheme of the Children and Family Relationships Bill 2014 given there is no sperm bank in Ireland and the sperm used in clinics here is imported from countries such as Spain, where anonymity is guaranteed.

This presents a significant difficulty when trying to ensure the child’s right to knowledge of its biological identity.

Without a national bank and given the use of imported sperm from countries that permit anonymous donation, how could Ireland establish a donor-conceived register that would enable identifying information about the sperm donor to be accessed by the child when he or she turns 18?

Pramatic reason

So, there is arguably a pragmatic reason why the general scheme of the new Bill does not contain any provision vindicating the child’s right to know his/her biological identity in the context of assisted reproduction: because current practice in this area makes it virtually impossible to guarantee this right.

This is unfortunate in a country where the people voted to insert express protection for children’s rights into the Constitution in 2012. In addition, both the Supreme Court and the European Court of Human Rights have recognised the importance to a child of accessing information about her/his biological identity.

Recent studies on donor offspring have revealed that an overwhelming number of donor-conceived individuals want information not only in relation to their donor, but also regarding any half-siblings that they might have.

Essential

Identifying information about one’s genetic parents can be essential to the mental health of individuals who have been donor-conceived.

If an Irish sperm bank were set up, the constitutional rights of the child and, indeed, best practice, would arguably preclude any anonymous donation of sperm.

This denial of donor anonymity, coupled with the establishment of a donor-conceived register, might discourage sperm donation and lead to a shortage of sperm donors in Ireland. This occurred in the Netherlands and Norway when they removed anonymity.

Nonetheless, even if there was a shortage of sperm donation as a result of all this, surely this outcome would be more acceptable than current clinical practice, whereby we are creating individuals who will never be able to know their biological parents.

Brian Tobin is a lecturer at the School of Law, NUI Galway

Jun201413

Reilly defends HSE leadership after calls for resignations

O’Brien (pictured) ‘on all of the major fronts you failed’

Minister for Health James Reilly has said the health services cannot be viewed as a business and PAC Chairman John McGuinness is wrong to attack the leadership who are maintaining services in difficult circumstances and have his confidence.

Mr Reilly said he agreed with the PAC chairman that the Health Service Executive structure is not fit for purpose.

He said the HSE would be replaced with a service that will work more effectively and improve outcomes for patients.

RELATED AUDIO & VIDEO

Minister Reilly said the Department of Health was also being reformed.

HSE Director General Tony O’Brien described a call for his resignation by Mr McGuinness as “political comments” and said he was sure Mr McGuinness had political reasons for making them.

Speaking to RTÉ News Mr O’Brien said his job is to run the health services in very difficult circumstances with continually diminishing resources and for that reason he was not going to enter into the rough and tumble of political commentary.

Mr O’Brien said he would focus on the interests of health service users and of staff and on continuing the continuous improvements of the health service.

Mr McGuinness said that hospitals are not being managed within their service level agreements and within budget.

He said: “It’s a business so on all of the major fronts you failed.

“And as a representative of the shareholders here, and I am sure if they were all here, they would probably look at you Mr McLoughlin as it’s you who negotiates the budget in house before it gets political on the other side, and Mr O’Brien that both of you should resign because it seems to me that this is sort of Groundhog Day.

Mr McLoughlin said that the recent expenditure reductions per capita in the Irish health service are the highest of any country in the OECD, with the exception of Greece.

He asked the committee to understand that as a civil servant he is obliged to carry out the decisions of the government and the minister in these matters, as is Mr O’Brien.

Mr McLoughlin added that he accepts “we are in an extremely challenging environment and we will do everything we can to take on board the constructive recommendations that you have made”.

He said that Ireland’s public health expenditure has lost €3bn since 2008, and 12,000 people.

He said they have been trying to do more services with less, but now they are have to do “less with less”.

He said that as a civil servant, he cannot enter the political realm but that he has done his best to discharge his duties as best he can in difficult circumstances over the past few years.

Concern over HSE budget planning

The Comptroller and Auditor General, Seamus McCarthy, has told the PAC that in each of the past five years, the HSE has sought a supplementary estimate as a result of emerging budget overruns.

He said this raises concerns about the effectiveness of its budget planning and budget management.

The C&AG said that there was a material level of ineligibility of card holding in the medical card scheme.

He said that the financial implication of that ineligibility has not been reliably established.

The Comptroller has recommended that the HSE initiate a cyclical programme of reviews of eligibility in respect of random cardholders, to establish the scale of excess payments.

Earlier, Mr O’Brien told the PAC that there were 143 individuals at Section 38 agencies who were getting top-ups.

He said that some of these staff have decided to leave the health service and some have taken reduced pay.

He said that others are asserting a contractual entitlement to the pay and these cases have to be worked through.

Mr O’Brien said the fact that they were in receipt of an unauthorised payment was not of their own doing.

He said the responsibility lay with the agency making the payment.

The HSE has asked employers to prove there is a contractual entitlement to being paid above the Government pay guidelines.

Mr O’Brien said he hoped to provide a full report on the issue to the PAC in early July.

Mr O’ Brien told the PAC that around eight people were asserting their contractual right to top-up pay.

In addition, more information is being sought from around 50 individuals.

He said that if some individuals are proven to have a contractual right, the HSE will have to discuss the issue with a number of Government departments.

Mr McGuinness asked the HSE to investigate the payment of over €258,700 a year in an agency fee, for the temporary filling of the post of deputy CEO/ Chief Operating Officer, at the University of Limerick Hospitals.

The payment was made between March 2013 and April 2014.

Mr O’Brien said the post had been advertised twice under the public appointments process and could not be filled.

He said the agency appointment was not permanent and the person was not an employee and he would also need to see if the payment related to more than one person.

Mr O’Brien said he would look into the issue but said he would not “investigate” it as this would suggest something else.

Elsewhere, the Dáil Committee on Procedure and Privileges has asked the PAC to provide more details about its application for compellability in relation to inquiries into Rehab and related matters before this might be granted.

The letter from the procedure committee asks the PAC to name the individuals it wants to compel.

It also notes that Rehab is not audited by the Comptroller and Auditor General.

At the PAC hearing today, Independent TD Shane Ross described the procedure committee’s letter as a refusal by any other name and claimed it was an attempt to nobble the PAC.

He suggested that the PAC get its own legal advice on its entitlement to compellability.

Other PAC members suggested the PAC seek to change its remit.

Mr McGuinness said the procedure committee met at 6pm yesterday evening and issued a two-page letter at 6.25pm looking for further information on two issues.

The first issue relates to the administration of the controversial SIPTU fund that is being looked into by the PAC.

The second issue relates to the Rehab organisation.

Mr McGuinness said that some Government departments could not give all the necessary information to the PAC relating to Rehab as “there were not in compellability mode”.

He said that it is up to the PAC to press for clarification by responding to the committee after seeking senior legal advice.

All of the members agreed that is the way the committee should proceed.

May201422

The Ashlin Centre, a new inpatient psychiatric unit for North Dublin Mental Health Services (NDMHS) has opened to patients
The Ashlin Centre, a new purpose built, inpatient psychiatric unit for North Dublin Mental Health Services (NDMHS) has opened to patients.

From Wednesday evening, 21st May, acute inpatient treatment and care for NDMHS general adult and psychiatry of old age services will be provided in this new centre.

The new unit, located on the Beaumont Hospital Campus replaces the acute inpatient unit formerly located in St. Ita’s Portrane (and which was located on a temporary basis since 2011 in the Joyce Rooms St. Vincent’s Fairview and Hawthorn Unit Connolly Hospital pending the completion of this new unit).

This new facility will serve a population of approximately 250,000 people in the North Dublin area. The building of this new unit is in line with the national mental health policy ‘A Vision for Change’.

The Joyce Unit, a general adult psychiatric admissions unit, on the ground floor comprises 38 single ensuite rooms. The Sheehan Unit, also on the ground floor, is a separate unit dedicated, to psychiatry of old age with six single ensuite rooms.

The new centre also has an extensive activities area including an Art room, project room, sensory room, conference room and four courtyard gardens. This uniquely designed mental health facility will provide a safe and therapeutic environment to facilitate service users journey to recovery.

Ann Martin
Press Officer
HSE Dublin North East

May201406

The Ashlin Centre, the new purpose built adult psychiatric admissions unit for North Dublin Mental Health Services will open to patients in late May. The new unit, located on the Beaumont Hospital Campus, will replace the acute admissions service formerly provided in St Ita’s Portrane.
This new facility will serve a population of approximately 250,000 people in the North Dublin area. The building of this new unit is in line with the national mental health policy ‘A Vision for Change’.
The Joyce Unit, a general adult psychiatric admissions unit, on the ground floor comprises 38 single ensuite rooms. The Sheehan Unit, also on the ground floor, will be a separate unit dedicated to psychiatry of old age with six single ensuite rooms.

The new centre also has an extensive activities area including an art room, project room, sensory room, conference room and four courtyard gardens. This uniquely designed mental health facility will provide a safe and therapeutic environment to facilitate service users journey to recovery.

Plans are also underway to develop the first floor of the new unit. This will include a new Renal Dialysis Unit for Beaumont Hospital as well as additional HSE Mental Health Services including a Psychiatry of Old Age Day Hospital, and a six bed Mental Health Intellectual Disability Admissions Unit.

Apr201424

The Irish Medical Organisation has said it is “appalled” by proposed legislation aimed at giving effect to the Government’s plans to introduce free GP care for children under 6 years.

The doctors’ trade union said that the legislation, published today by the Department of Health represented draconian measures which would destroy the very fabric of general practitioner services in Ireland.

As The Irish Times has reported over recent weeks the legislation will allow for the Minister for Health to set, and potentially vary, fees paid for GP services under thenew contract.

The legialtion would also remove children under six from the provisions of the existing GMS contract and place them under the new scheme.

In essence this means that GPs who currently are paid to treat children under age 6 as part of the medical card scheme and who wish to continue to do so will have to sign up to the new contract.

Similarly parents of children under 6 with a medical card would in future have to pay privately if they wanted to remain with a GP who did not opt for the new contract.

The proposed legislation provides for consultations to be held between the Minister and representatives of GPs in relation to the fees to apply under thenew contract for treating children under age 6.

However it says that the Minister may define the manner under which such consultations would be conducted. The proposed consultations would be limited to 60 days duration. The proposed legislation says that nothing in competition law would prevent participation in such consultations.

The chairman of the GP Committee of the IMO Dr Ray Walley said the legislation “had exceeded our worst fears”.

He said it gave the lie to the argument by Government that the move was about extending free GP visit cards to children under 6.

“This legislation has nothing to do with GP visit cards for children. It is nothing less than a unilateral attempt to replace the long-standing GMS Contract with a new, draconian contract which will destroy the very fabric of the GP service in Ireland and there are very serious concerns as to the future viability of the service.”

The IMO maintained the Government’s proposals would institutionalise the provisions of emergency legislation (FEMPI) in regard to GPs, force GPs to move to the new contract by removing existing GMS patients to the new scheme, abolish the right of the IMO to negotiate on behalf of its GP members and allow the Minister to vary the fees without any negotiation at any time

Dr Walley said the proposed legisaltion would “effectively destroy general practice and should not be enacted”.

“It reflects an arrogant mindset by an arrogant Government that should know better. On the one hand the Minister says he wants to talk to the IMO while on the other he publishes legislation that appears to make talks a futile exercise.”

“This is a line in the sand moment not just for individual GPs but for the continued viability of the GP model in Ireland.”

Apr201414

Dr. James Reilly, T.D., Minister for Health today (Friday, 11th April, 2014) officially opened Connolly Street Primary Care Centre, the Acute Medical Assessment Unit (AMAU) and Cystic Fibrosis (CF) Outpatient Suite at Cavan General Hospital.
Commenting on Connolly Street Primary Care Centre Minister Reilly said “In a developed primary care system, up to 95 per cent of people’s day-to-day health and social care needs can be met in the primary care setting, thereby avoiding the need for them to go to hospital. This new centre helps to develop services in the community giving people direct access to integrated multi-disciplinary teams of health care professionals. It will benefit the residents of Cavan Town and surrounding areas by providing them with access to quality healthcare resulting in better health outcomes.”
Officially opening the new Cystic Fibrosis Outpatient Suite at Cavan General Hospital, the Minister said “This new facility will improve the quality of life for CF patients in Cavan and in the surrounding areas by facilitating ambulatory daycare as close to home as possible. A welcome and positive development as it minimises the risk to CF patients of exposure to infection and will also reduce the need for CF inpatient admissions. I commend the hospital and the Cavan Branch of Cystic Fibrosis Association of Ireland.”
Speaking about the new Acute Medical Assessment Unit he said “It is striking that in the first three months of this year there have been just 189 patients waiting on trolleys at Cavan Hospital: in 2011, during the same period there were 1,542 patients waiting on trolleys. This is almost an 88% decrease in the numbers, which shows clearly the very positive benefits of the AMAU for Cavan Hospital, and I congratulate all those involved in the planning, development and successful running of the Unit for all that they have achieved.”

Connolly Street Primary Care Centre which became operational in June 2013 is made up key health services staff including; public health nursing, physiotherapy, occupational therapy, speech and language therapy and Farnham Medical Practice is also located in the centre. The primary care team members liaise and work alongside a range of outreach services including dieticians, psychologists, social workers and community welfare officers. In addition to primary care services the following services are also delivered from the centre; Child and Adolescent Mental Health Services, Counselling in Primary Care, National Diabetic Retinopathy Service, Community Paediatric Dietician and Consultant Paediatrician. Connolly Street Primary Care Centre is one of two Primary Care Centres in Cavan town, the other is located in Drumalee. The two Primary Care Teams serve a population of 20,572 living in Cavan town and the surrounding areas including Ballyhaise, Butlersbridge, Stradone, Denn and Ballinagh.

The CF Suite contains two out-patient treatment rooms, which provides a separate designated area for both adults and children with cystic fibrosis to receive their care and treatment in and reduce the risk of cross infection. Developed as a joint initiative between Cavan and Monaghan Hospital and the Cavan Branch of Cystic Fibrosis Ireland, the facility has greatly enhanced the management and care of all CF patients from Cavan, Monaghan and the surrounding counties who attend the hospital.

Speaking at the official opening the new Cystic Fibrosis Outpatient Suite at Cavan General Hospital, Raymond Dunne, Chairperson of the Cavan branch of Cystic Fibrosis Ireland said ” It is truly an historic, watershed moment in the lives of people with Cystic Fibrosis (PWCF) from the area. The new Cystic Fibrosis Outpatient Suite at Cavan General Hospital represents a major step in the avoidance of cross infection and will bring peace of mind to PWCF. It makes specialised, complex, multidisciplinary care deliverable in a safe environment. I would like to record our appreciation and gratefulness to so many in HSE associated with this project and to Minister Reilly for all your help in making the realisation of a vision /dream come true in this most welcome, wonderful, magnificent facility”.

The Acute Medical Assessment Unit (AMAU) at Cavan General Hospital provides urgent assessment and care for patients with medical conditions. The unit which is consultant led allows for patients presenting at the hospital to be assessed and treated in an approximately 3 to 4 hour timeframe. The AMAU which initially opened in 2009 as a 6 patient assessment area was relocated in December 2012 to an area adjacent to the Emergency Department and expanded to provide capacity for 10 patient assessment areas including 2 single rooms to cater for patients with infections. The new AMAU facilitates more capacity for patients presenting direct to the AMAU and medical patients who previously were being assessed in the Emergency Department.

Leo Kinsella, Area Manager, HSE Cavan Monaghan said “all of the facilities officially opened today have as their primary focus the delivery of integrated care by putting the patient and their needs at the centre of our local health care system. These first class facilities are helping our clinicians and staff better respond to our clients needs, improving collaboration across disciplines while supporting our goal of better access to local health and social care for all our citizens.”

The Minister for Health also visited St. Mary’s Hospital in Castleblayney and viewed the major capital project works that are underway. The works which are scheduled for completion in April 2015 will provide a fully compliant and modern residential home and will further improve the quality and standard of services provided to residents.